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Notes:
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POCKET RESOURCE GUIDE
Welcome
Albert C. Hergenroeder, M.D.
Chief of Adolescent Medicine Service and Sports Medicine Clinic,
Texas Children’s Hospital
Professor of Pediatrics, Baylor College of Medicine
Joseph N. Chorley, M.D.
Staff Physician, Sports Medicine Clinic, Texas Children’s Hospital
Associate Professor of Pediatrics, Baylor College of Medicine
The Texas Children’s Hospital Family Fun Run Pocket Resource Guide is designed
to provide educational information only to help parents educate children on the
importance of physical activity. It is not the intention of the physicians or health
care providers who contributed to this guide to provide specific professional
medical advice or establish any professional relationship with any reader of
this guide or any information contained therein. If any reader of this guide is
experiencing any symptoms of ill health, please contact a licensed medical
doctor to diagnose, treat and professionally address those medical needs
before beginning any of the activities contained in this guide. No portion of
this guide may be reproduced without the express written consent of Texas
Children’s Hospital.
Introduction
Families with children of all abilities are invited to participate
in the annual Texas Children’s Hospital and Houston Marathon
Foundation Family Fun Run at Texas Children’s Hospital West
Campus. This event, formerly known as the Kids’ Fun Run,
has a rich history of over 15 years with our hospital. We are
very excited to now include the entire family to educate and
encourage Houston-area children and their families to adopt
active, healthy lifestyles!
The Family Fun Run will include both a 1K and 3K course.
Participants of all abilities, including those needing walkers
and wheelchairs, are welcome. There will not be prizes given
for top finishers; all will receive an award for participating!
To prepare yourself and your children for the Family Fun Run,
please use this pocket guide as a resource. Other videos and tools
to get you ready to run are also available at texaschildrens.org/
funrun. We look forward to your participation in our event.
Table of Contents
CHAPTER 1 | Getting a safe start |
5
CHAPTER 2 | Fitness for life (keeping a fitness journal) |
6
CHAPTER 3 | Safety |
7
CHAPTER 4 | Heat, humidity and hydration |
8
CHAPTER 5 | Performance-based nutrition | 11
CHAPTER 6 | Proper running gear and protection | 13
CHAPTER 7 | The cardiovascular system | 15
CHAPTER 8 | The musculoskeletal system | 17
CHAPTER 9 | The metabolic system | 19
CHAPTER 10 | Rest and sleep | 20
CHAPTER 11 | Race preparation
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5
Chapter 1
Notes:
GETTING
A SAFE START
CARDIAC CONCERNS
Children with a history of heart problems or a heart murmur need clearance
from their doctor before participating. Those who faint, nearly faint, have chest
pain or have an irregular heart beat during exercise cannot exercise until their
physician clears them. In addition, children who have a parent or sibling who
died from a heart problem before the age of 50 need clearance from their
doctor before they participate.
Prior to participating
in any physical activity
program, have your
child evaluated by a
physician.
Certain conditions may
affect your child’s physical
activity program.
MUSCULOSKELETAL ISSUES AND INJURIES
Injuries that have not been properly rehabilitated can be a risk factor for
subsequent injuries as a child starts a running or other physical activity program.
Injuries from a previous running program will happen again if the cause of the
problem is not addressed. Be sure to have your child evaluated and diagnosed
if he or she has any issues with previous injuries.
PRE-EXISTING MEDICAL CONDITIONS
If your child has a chronic condition such as asthma, diabetes or seizures, he or
she may still continue to participate in physical activities under the guidance
of a physician. The key is optimal management of these conditions to minimize
their impact on physical activity and daily living.
OVERWEIGHT/OBESITY
Overweight and/or obese children should be allowed to walk and run as much
as they can tolerate and should have unlimited access to water during training.
Chapter 2
Activity:
FITNESS FOR LIFE
To begin building endurance, have your child complete the following activities
below at least three times during each week. Children should train in the
manner they plan to compete in the race. For example, if they plan to run,
they should follow the run column.
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(KEEPING A FITNESS JOURNAL)
6
Have your child keep a daily
workout journal during the
training program. The journal
should include warm-up,
selected physical activities,
cool-down and time spent
on each activity. Activities
may represent those done
in or out of school.
See this eight-week training schedule for race preparation.
WEEKS UNTIL RACE
RUN
WHEELCHAIR
8 WEEKS
1 min., 30 sec.
2 minutes
7 WEEKS
2 min., 45 sec.
3 minutes
6 WEEKS
3 min., 30 sec.
4 minutes
5 WEEKS
6 minutes
6.5 minutes
4 WEEKS
9 minutes
10 minutes
3 WEEKS
13 minutes
12 minutes
2 WEEKS
15 minutes
15 minutes
1 WEEK
18 minutes
18 minutes
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Chapter 3
7
Notes:
SAFETY
• Avoid running if the temperatures are too hot. Early morning walking/running
When beginning a running
training program, safety is
key. Follow these simple
guidelines to make sure
your child stays protected
and minimizes the risk
of injury.
• Be aware that drivers may not be looking for walkers or joggers. Have your child
may have a lower heat index in the summer than mid-day or afternoon running.
wear white, bright colors or a reflector badge on his or her shirt.
• Your child should warm up by walking for two to three minutes before running.
• After warm-down, stretching is appropriate. Stretches should be held for at
least 20 seconds and repeated two to three times.
• Children with special health care needs may require adaptations that can be
developed with a physician, therapist and/or instructors. For instance, children
with visual impairments may need to participate in activities with a partner.
The partner can be given instructions about verbal directions or how to
physically guide the child who is visually impaired.
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Chapter 4
Notes:
HEAT, HUMIDITY AND
HYDRATION
MONITORING HYDRATION
Bodies are about 65% water, and any quick change in weight is because of
changes in fluid balance. Monitoring weight before and after exercise is a
practical and quick way of monitoring fluid loss during activity. This is known
as a “sweat rate.” Losing one pound during exercise is equal to a 16 ounce
fluid loss, or about the size of an average water bottle.
As your child begins a
training program, be sure
he or she stays adequately
hydrated.
Here are some practical
ways of monitoring hydration
and dietary tips to improve
fluid balance.
Another quick way to assess hydration is the color of urine. In general, urine
should be the color of pale lemonade. If urine looks like apple juice, you are
likely dehydrated. According to the American College of Sports Medicine, the
goal of drinking before, during and after exercise is to prevent weight loss
of greater than 2% of total body weight during physical activity. Being wellhydrated can actually improve an athlete’s performance.
IMPROVING FLUID BALANCE
Fluids come from two main sources – fluids you drink and fluids you eat. The
best hydration beverage is water, and if the duration of exercise is under an
hour, plain water is preferred. Sports drinks are appropriate for exercise
greater than an hour and during hard training.
Sports drinks provide carbohydrates and electrolytes and because of the flavoring,
children will often drink more of these beverages than they will drink of water,
helping to maintain hydration. Sports drinks can be used before, during and
after exercise, but have little value in the lunch box or at meal times.
Activity:
Chapter 4 continued
• Have your child estimate how much fluid is consumed in a gulp of water to
estimate how many gulps of fluid he or she will need to take in during training.
• Set up a water station with cups or water bottles along the training route to
practice drinking while exercising.
• During the training program, have your child keep a daily log journal tracking
their fluid intake to ensure proper hydration.
Name
Date
Volume of fluid consumed in a day
Comments
Chapter 4 continued
PREVENTION OF HEAT INJURY: Heat injury encompasses a wide range of effects on the body from too much heat and/or humidity and not
enough hydration during physical activity. If not treated, this condition can become very serious.
• Drink one to two cups of water two
• Water is the best drink unless the exercise • It takes 10 to 14 days of heat exposure
• Stay in the shade as much as possible
• Start conditioning slowly before the
to three hours before exercise.
when not competing.
is continuous and greater than an hour.
(15 to 30 minutes in the heat each day) for
your child’s body to acclimate to the heat.
training session begins.
• The best fluid to drink during competition
is the fluid your child has been drinking
during training.
•
Drink the minimum of one to two cups
of water about every 20 to 30 minutes
during competition.
• The colder the water, the faster it
is absorbed.
• Drink even when not thirsty. Thirst will
underestimate how much fluid is needed.
• DO NOT TAKE SALT TABLETS. They are
unnecessary and may be dangerous.
• Wear loose-fitting clothing (i.e., cotton
blend/light colored).
• Do not drink sodas, caffeinated or
carbonated drinks or fruit juices
during exercise.
Heat Injury Symptoms
•
•
•
•
•
•
•
EARLY SIGNS
Goosebumps on chest and upper arms
Headache
Unsteadiness or dizziness
Nausea
Muscle spasms or cramps
Muscle fatigue
Profuse sweating
If your child experiences these warning signs,
he or she should stop physical activity, begin
oral rehydration in a cool, shaded environment
and consult a trainer or a physician.
LATE SIGNS
• Confusion
• Exhaustion
• Unconsciousness
• Dry skin
• Rising body temperature
• Vomiting
At this stage, the athlete is in extreme danger.
A doctor should be consulted and emergency
measures begun. Emergency medical services
(EMS) should be called for transportation to an
emergency center. Remember that the effects
of competing in hot weather are additive. This
means that one is more likely to develop heat
illness on the second or third day of competition
if attention is not paid to drinking the necessary
amounts of fluid during the first two days
of competition.
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Chapter 5
Notes:
PERFORMANCE-BASED
NUTRITION
IS MY CHILD GETTING ENOUGH PROTEIN?
Protein is necessary to build and repair muscle and to boost the immune
system. The need for protein in an athlete is increased, but many athletes
over-consume protein and under-consume calories. Your child can make
healthy protein choices by choosing lean meats (turkey, fish, sirloin, beans,
tofu), using egg whites instead of whole eggs, choosing low-fat dairy products
(skim milk, 1% milk, low-fat yogurt), and avoiding fried meats. Having protein
at each meal helps muscles to recover and get ready for more physical activity.
Good nutrition is important,
but it goes beyond the way
we look and feel. For children,
maintaining a balanced diet
is critical to the health, growth
and development, safety and
success in their sport.
Eating the right kinds of foods
at the right time can help
provide the sustained energy
during exercise and promote
the recovery muscles need
after strenuous exercise.
ARE CARBOHYDRATES IMPORTANT?
Quality carbohydrates are the fuel of exercising muscle. Carbohydrates consist
of both sugars and starches. Sugars appear in cookies, candies, cake, pies and
many snacks that children love. The sugars in these foods often contain large
amounts of fat, making them unsuitable for athletic performance. The staple of
the well-fueled athlete are starches such as bread, rice, beans, some fruits and
vegetables. If physical activity is quickly approaching, it is best to use a sports
drink or carbohydrate gel/honey.
If your child has more time, foods like whole grain cereal and milk or graham
crackers with some peanut butter and honey would be a good choice. A low-fat
meal such as chicken, spaghetti or a sandwich with fruit can also be considered part
of your child’s performance plate. Protein alone does not fuel muscles for activity.
Chapter 5 continued
HOW SHOULD I PLAN MEALS FOR MY CHILD?
When foods are chosen by a few basic principles, the plate becomes an ally in
the prevention of chronic illness and a strategy to improve performance. The
principles are simple: choose a plate rich in colorful produce, quality whole
grain carbohydrates and lean protein.
• About half of children’s plates should be fruits and vegetables, which are 90%
water, and can help prevent dehydration.
• Whole grain carbohydrates such as whole grain pasta, brown rice, oatmeal
and 100 percent whole wheat bread should take up one-fourth of their plate.
These high fiber foods contribute to a sense of fullness and may aid in weight
reduction. If your child doesn’t like these whole grain foods, consider food that
has some whole wheat in it. There are pastas, for example that combine white
and whole wheat flours to make a less chewy product.
• Lean protein should be approximately one-fourth of the plate and should be
consumed at each meal. Some protein suggestions for breakfast include
flavored Greek yogurt, egg whites or Canadian bacon added to the first
meal of the day.
Visit kidseatright.org and choosemyplate.gov for meal-planning ideas.
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Chapter 6
Activity:
PROPER
RUNNING
GEAR
Have your child place his or her wet foot in the middle of a dry towel so the
impression of the foot will appear. Then, he or she will be able to identify
his or her foot type.
It’s important that children
understand the importance
of wearing proper running
shoes and gear as they
directly affect both comfort
level and performance.
Œ

Ž
Œ The “flat” or pronator foot type has a low arch and an imprint that looks
like the entire sole of the foot. While running, a person with a flat foot usually
strikes on the outside of the heel and rolls inward excessively.
 The “normal” or neutral foot type has a normal-sized arch and an imprint
that shows the forefoot and heel connected by a wide band. While running,
a person with a normal foot lands on the outside of the heel, then rolls slightly
inward to absorb shock.
Ž The “high-arch” or supinator foot shows a very narrow band connecting
the forefoot and heel. This foot type is not an effective shock absorber.
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Chapter 6 continued
Notes:
PROTECTION
COLD WEATHER CLOTHING
Layering allows children to adjust to changes in weather as well as changes
in body heat generated. The deepest layer should allow sweat evaporation
and the outer layer should be water/wind resistant. Middle layers should be
designed for warmth and insulation. A hat will also protect against heat loss
from the head.
Protecting your child’s skin
with sunscreen is essential
at all times, regardless of
the weather. Even if the sky
is cloudy and overcast, UVB
sun rays can still damage
your skin.
Children who use walkers
or wheelchairs may want to
wear gloves to reduce the
risk of developing blisters
on their hands.
WARM WEATHER CLOTHING
White-colored shirts are preferred during hot weather as they do not absorb
as much heat. Cool/thin clothes that have breathable material allow the body
to cool quickly.
SHOES
It is best for children to tie their shoelaces each time they put shoes on their feet.
Most running shoes will last six to nine months or 300 to 500 miles. The main
types of shoes are:
• Motion control
• Stability
• Cushioned
The best running shoe is the one that fits well, feels comfortable and is built
to support the differences in people’s feet.
• Those with a “flat” or pronator type foot need stability or
motion control shoes.
• Those with neutral and high-arched feet need cushioned shoes.
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Chapter 7
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Notes:
Cardiorespiratory endurance will improve in response to a running training program.
Numerous cardiovascular adaptations occur in response to training, including:
THE CARDIOVASCULAR
SYSTEM
• Heart size will increase due to hypertrophy of cardiac muscles and increased
The cardiovascular system
is responsible for pumping
blood and delivering nutrients
throughout the body as well
as removing gaseous wastes.
can pump blood more effectively. In other words, cardiac output increases.
These organs are at the heart
of training. It’s important to
learn to monitor their output.
size of the heart chambers due to increased blood volume.
• This hypertrophy of the cardiac muscles means that the heart is stronger and
• Because the heart beats stronger, the number of contractions per minute
(the heart rate) will be lower after a training program compared to before
the training program. Specifically, in a sedentary person, the resting heart
rate will decrease during the initial phase of a training program by an average
of one beat per minute for each week in training.
• The number of small blood vessels (capillaries) to muscles involved with training
will increase, resulting in greater blood flow and oxygen delivery to those muscles.
This results in the person being able to exercise for a longer period of time.
• Resting blood pressure typically goes down to 11 mm Hg (systolic)and 8 mm Hg
(diastolic) in border line hypertensive or hypertensive people after an aerobic
training program.
• Children with a heart or blood pressure problem should consult with a physician
and get approval for participation or proper restrictions on physical activity.
Chapter 7 continued
Activity:
HOW IS
YOUR CHILD’S
HEART RATE?
Have your child guess his or her heart rate for 15 seconds and fill in the chart.
Then, have your child place his or her index and middle finger on his or her
neck or wrist. Count how many beats he or she feels in 15 seconds and fill in
the chart. Multiply by four to get his or her heart rate per minute, fill in the
chart and compare to the ranges to the left.
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(PER MINUTE)
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• Excellent (70-79)
• Good (80-89)
• Above average (90-99)
Guess what your own heart rate will be for 15 seconds and fill in the chart.
Then, place your index and middle finger on your neck or wrist. Count how
many beats you feel in 15 seconds and fill in the chart. Multiply by four to get
your heart rate per minute and fill in the chart. Your heart rate should be lower
than your child’s.
• Average (100-105)
• Below average (106-115)
• Poor (116-129)
• Very poor (Greater than 130)
Child
15 second heart rate (guess)
15 second heart rate (actual)
Heart rate per minute (guess)
Heart rate per minute (actual)
Parent
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Chapter 8
Activity:
THE
MUSCULOSKELETAL
SYSTEM
Discuss why muscles get sore during the onset of or change in exercise
or physical activity.
The musculoskeletal
system describes your
muscles, bones and how
they interact via joints,
ligaments and tendons.
Training programs can
often lead to soreness
as these muscles start
to fatigue.
What happens to sore muscles when an individual continues to exercise or
participate in physical activity?
Ask your child to list the names of each family member living in your household,
including yourself. Log the number of times each person can squeeze a ball
before fatigue sets in.
Name
Number of times ball squeezed
Comments
Chapter 8 continued
Medical Notes:
• Muscles and bones adapt to running training by becoming stronger as long as
the training is gradual and at an appropriate weight-bearing load for the person.
If the running program is too long, too fast or increases the training volume too
fast, muscles and bones can be injured in the form of strains and stress fractures.
• Weight-bearing exercise can cause bones to be stronger. Muscles involved in
running will have more small blood vessels (capillaries) flowing into the muscles
as an adaptive response to exercise. This means the muscles can do more work
(e.g., running faster and longer) after an effective running training program.
• While a child is recovering from an injury, stretching, strengthening, endurance
and balance exercises specifically for rehabilitating the injury should be performed.
Exercise to maintain general cardiopulmonary fitness should be done. Riding an
exercise bicycle during physical education class is often a good way to improve
cardiovascular fitness and make the legs stronger while letting overused injuries
of the lower extremities recover. These exercises could be done during physical
education class if the child is unable to participate in the training plan for that day.
• Lower extremity muscles may increase in size in response to a running training
program. For children who use wheelchairs, upper extremity muscles will
increase in size.
Chapter 9
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THE METABOLIC SYSTEM
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Exercise has a direct effect
on the glucose, insulin,
muscle and blood lipids
in a body.
Being physically fit can lead
to more energy and avoid
health challenges such as
type 2 diabetes mellitus.
Notes:
• Type 1 diabetes mellitus (T1DM) has been referred to as “juvenile onset”
diabetes mellitus, as it usually begins in childhood or adolescence. In T1DM,
not enough insulin is produced; therefore, glucose does not enter the cells of
the body as easily as it normally would. This causes the blood sugar level to
be high, and the person can develop life-threatening ketoacidosis.
• Type 2 diabetes mellitus (T2DM) traditionally has been called “adult onset”
diabetes mellitus because it was seen primarily in adults. However, more
children and teenagers are being diagnosed with T2DM. This is because obesity
has increased among children and teens, and obesity causes insulin resistance.
In T2DM the insulin level is elevated, yet the cells of the body are resistant to
insulin (hence the term “insulin resistance”) resulting in high blood sugar levels.
Usually these patients do not develop life-threatening ketoacidosis.
T2DM increases a person’s risk of heart attack, stroke and kidney failure.
The more physically active a person is, the less likely he or she is to have T2DM.
Evidence suggests that increased physical activity can prevent or delay the onset
of T2DM.
Physical activity tends to improve glucose control in people with T2DM.
Chapter 10
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REST AND SLEEP
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Getting adequate amounts
of sleep affects your child’s
life and training program.
A well-rested child has
improved memory,
metabolism and
overall health.
Notes:
REST
Before
race day, take two to three days per week without running
•
to allow your child’s body to recover.
• Participating in other physical activities can maintain and build
fitness while decreasing injuries.
SLEEP
• Teenagers need approximately nine hours of sleep per night.
• Prolonged naps during the afternoon hours can interrupt restful
nighttime sleep.
• Sleep hygiene means avoiding naps and getting eight to nine
hours uninterrupted sleep at night.
Chapter 11
Notes:
RACE PREPARATION
ARE YOU READY TO RUN?
• Check weather forecast
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• Prepare proper clothing
21
• Get plenty of sleep
• Mental preparation
• Pack a race day bag
• Warm-up and stretch
• Pre-race nutrition and fluid
2017 Texas Children’s Hospital. All rights reserved. FFR071 FFR Pocket Guide